title: An autopsy case of otogenic intracranial abscess and meningitis with Bezold's abscess: evaluation of inflammatory bone destruction by postmortem cone-beam CT.
abstract: The deceased was an unidentified young male found unconscious on a walkway. On autopsy, outer and inner fistulae of the left temporal bone, subcutaneous abscess in the left side of the neck and head, and an intracranial abscess were noted. A portion of the left temporal bone was removed and scanned by cone-beam computed tomography (CT) (normally used for dentistry applications) to evaluate the lesion. The cone-beam CT image revealed roughening of the bone wall and hypolucency of the mastoid air cells, consistent with an inflammatory bone lesion. According to autopsy and imaging findings, the cause of death was diagnosed as intracranial abscess with Bezold's abscess secondary to left mastoiditis as a complication of otitis media. Although determining the histopathology of bone specimens is time-consuming and costly work, we believe that use of cone-beam CT for hard tissue specimens can be useful in forensic practice.
authors.affiliation: Department of Forensic Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa-shi, Saitama 359-8513, Japan; Tokyo Medical Examiner's Office, Tokyo Metropolitan Government, Japan. Electronic address: ykanawaku@nifty.com.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Kanawaku
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yanase
authors.forename: Kino
authors.initials: K
authors.lastname: Hayashi
authors.forename: Kazuki
authors.initials: K
authors.lastname: Harada
authors.forename: Jun
authors.initials: J
authors.lastname: Kanetake
authors.forename: Tatsushige
authors.initials: T
authors.lastname: Fukunaga
mesh_terms: D000038:Abscess / Q000000981:diagnostic imaging* / Q000209:etiology; D000328:Adult; D001922:Brain Abscess / Q000000981:diagnostic imaging / Q000209:etiology; D054893:Cone-Beam Computed Tomography / Q000295:instrumentation / Q000379:methods; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging / Q000209:etiology; D049429:Forensic Pathology / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008416:Mastoid / Q000000981:diagnostic imaging / Q000473:pathology; D008417:Mastoiditis / Q000150:complications / Q000000981:diagnostic imaging*; D008581:Meningitis / Q000150:complications / Q000000981:diagnostic imaging*; D019838:Neck Injuries / Q000000981:diagnostic imaging / Q000209:etiology; D017695:Soft Tissue Injuries / Q000000981:diagnostic imaging* / Q000209:etiology
keywords: Bezold’s abscess; Cone beam CT; Mastoiditis; Meningitis; Otitis media; Subdural abscess